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Introduction Some clinicopathological indicators were reported as poor prognosis of invasive ductal adenocarcinoma of pancreas. The aim of this study is to find out the new indicator for prognosis. Download : Download full-size image Methods Two hundred forty-nine patients with invasive ductal adenocarcinoma of pancreas who underwent macroscopically radical resection between 2000 and 2009 were retrospectively analyzed. Eleven clinicopathological factors were obtained from a review of the medical charts. Analyses of survival were performed using Kaplan-Meier method, and differences between the curves were tested using log-rank test. Factors related to survival were analyzed with the Cox proportional hazards regression model. Results The overall 1, 3, 5 year survival rates were 78.7, 32.1, 25.3% with 22.0 months in median survival time. Median follow up time of all survivors was 33.0 months. There were 27 patients who survived more than 5 years. There were 45 patients with CEA>5.0, 59 patients with CA199>500 and 23 patients with both. In the analyses of survival, 9 factors: preoperative CEA>5.0 ug/dl (p=0.02), CA199>500IU/l (p=0.04), right side tumor location (p=0.07), tumor size>2cm (p=0.07), pathological poor differentiation of tumor (p Conclusion Elevated preoperative CEA level was the new indicator of the poor prognosis and the patients with that should be considered to be performed neoadjuvant therapy followed by surgery.